Warming therapy patient care units with automated weaning modes

ABSTRACT

Disclosed herein is a system including a patient support unit having an enclosed patient environment, a heating module, a skin temperature sensor module, an environmental sensor module and a control system. The control system is configured to selectively operate the system in a pre-programmed weaning mode configured to gradually wean the patient from the warmed patient environment according to a series of stepped air temperature decreases performed over a series of stepped time durations to achieve a goal air temperature while maintaining a goal skin temperature within a weaning abort deviation. Related apparatus, systems, methods and/or articles are described.

REFERENCE TO PRIORITY DOCUMENT

This application claims the benefit of priority under 35 U.S.C. §119(e)of U.S. Provisional Patent Application Ser. No. 61/550,289, filed Oct.21, 2011. Priority of the aforementioned filing date is hereby claimedand the disclosure of the provisional patent application is herebyincorporated by reference in its entirety.

TECHNICAL FIELD

The subject matter described herein relates to automatically monitoringand controlling the rate of temperature change of in an incubator orwarmer environment.

BACKGROUND

Medical incubators and warmers are typically used to provide heatsupport to patients, such as premature infants, who cannot maintaintheir own body temperature. Closed incubators produce the necessaryclimate including temperature, relative humidity and oxygen content.Open care units and warmers generally only provide temperatureregulation usually with heat radiation source and conductive heatedmattress.

SUMMARY

In one aspect, provided herein is a system including a patient supportunit having an enclosed patient environment, a heating module, a skintemperature sensor module, an environmental sensor module and a controlsystem. The heating module includes a heater and a heating modulecontroller operatively coupled to the heater. The heater is configuredto warm the patient environment. The skin temperature sensor moduleincludes a skin temperature sensor and a skin temperature controlleroperatively coupled to the skin temperature sensor and to the heater.The skin temperature sensor is configured to measure a skin temperatureof a patient in the patient environment. The environmental sensor moduleincludes an air temperature sensor and an air temperature controlleroperatively coupled to the air temperature sensor and to the heater. Theair temperature sensor is configured to measure the air temperature inthe patient environment. The control system includes at least oneprocessor, at least one memory coupled to the at least one processor andincluding at least one program stored thereon, and at least one inputinterface. The control system is configured to selectively operate thesystem in a pre-programmed weaning mode configured to gradually wean thepatient from the warmed patient environment according to a series ofstepped air temperature decreases performed over a series of steppedtime durations to achieve a goal air temperature while maintaining agoal skin temperature within a weaning abort deviation.

The heating module controller can be regulated by the control system tolimit heating energy from the heater to achieve an air temperatureset-point within one in the series of stepped time durations. The airtemperature set-point can equal the air temperature of the patientenvironment measured at a start of one in the series of stepped timedurations plus one in the series of stepped temperature decreases. Theweaning mode can end once the goal air temperature is achieved and theskin temperature of the patient is equal to or greater than the goalskin temperature less the weaning abort deviation. The goal airtemperature can be between about 20° C. to about 39° C. The goal skintemperature can be between about 34° C. to 38° C. Each in the series ofstepped air temperature decreases can be between about 0.2° C. to 1.0°C. Each in the series of stepped time durations can be at least about 1,2, 4, 8, 12, 18, or 24 hours. The weaning abort deviation can be betweenabout 0.3° C. to 1.0° C.

The environmental sensor module can further include one or more oxygensensors. The one or more oxygen sensors can be coupled to a servo oxygencontroller operationally coupled to an oxygen valve configured todeliver controlled amounts of oxygen to the patient environment. Theenvironmental sensor module can further include one or more humiditysensors. The one or more humidity sensors can be coupled to a humidityheater and a humidity controller configured control the humidity heaterto regulate moisture content in the patient environment. The heater caninclude one or more of a main air heater, a mattress heater, a radiantheater, or a humidity heater. The patient can be a premature orfull-term newborn baby.

In an interrelated aspect, provided herein is a method includingsupporting a patient in a patient environment of an incubator. Theincubator includes a heating module, a skin temperature sensor module,an environmental temperature sensor module, and a control system. Theheating module includes a heater and a heating module controlleroperatively coupled to the heater. The heater is configured to warm thepatient environment. The skin temperature sensor module includes a skintemperature sensor and a skin temperature controller operatively coupledto the skin temperature sensor and to the heater. The skin temperaturesensor is configured to measure a skin temperature of the patient in thepatient environment. The environmental temperature sensor moduleincludes an air temperature sensor and an air temperature controlleroperatively coupled to the air temperature sensor and to the heater. Theair temperature sensor is configured to measure the air temperature inthe patient environment. The control system includes at least onedisplay, at least one processor, at least one memory coupled to the atleast one processor and including at least one program stored thereon,and at least one input interface. The method further includes receivinga command by the control system to perform a pre-programmed weaning modeprotocol configured to gradually wean the patient from the warmedpatient environment according to a series of stepped air temperaturedecreases performed over a series of stepped time durations to achieve agoal air temperature while maintaining a goal skin temperature within aweaning abort deviation.

The method can further include prompting a user on the display toidentify one or more of the stepped air temperature decreases, thestepped time durations, the goal air temperature, the goal skintemperature, and the weaning abort deviation. The method can furtherinclude automatically measuring the current skin temperature of thepatient using the skin temperature sensor and continuously communicatingthe measured current skin temperature to the control system. The methodcan further include automatically regulating the heater module to limitheating energy from the heater to achieve an air temperature set-pointwithin one in the series of stepped time durations. The air temperatureset-point can equal the air temperature of the patient environmentmeasured at a start of one in the series of stepped time durations plusone in the series of stepped temperature decreases. The method canfurther include comparing the skin temperature of the patient to thegoal skin temperature over the step duration. The weaning mode protocolcan end once the goal air temperature is achieved and the skintemperature of the patient measured is equal to or greater than the goalskin temperature less the weaning abort deviation. The goal airtemperature can be between about 20° C. to about 39° C. The goal skintemperature can be between about 34° C. to 38° C. Each in the series ofstepped air temperature decreases can be between about 0.2° C. to 1.0°C. Each in the series of stepped time durations can be at least about 1,2, 4, 8, 12, 18, or 24 hours. The weaning abort deviation can be betweenabout 0.3° C. to 1.0° C.

The environmental sensor module can further include one or more oxygensensors. The one or more oxygen sensors can be coupled to a servo oxygencontroller operationally coupled to an oxygen valve configured todeliver controlled amounts of oxygen to the patient environment. Theenvironmental sensor module can further include one or more humiditysensors. The one or more humidity sensors can be coupled to a humidityheater and a humidity controller configured control the humidity heaterto regulate moisture content in the patient environment. The heater caninclude one or more of a main air heater, a mattress heater, a radiantheater, or a humidity heater. The patient can be a premature orfull-term newborn baby.

Articles of manufacture are also described that comprise computerexecutable instructions permanently stored on non-transitory computerreadable media, which, when executed by a computer, causes the computerto perform operations herein. Similarly, computer systems are alsodescribed that may include a processor and a memory coupled to theprocessor. The memory may temporarily or permanently store (e.g.,non-transitorily store, etc.) one or more programs that cause theprocessor to perform one or more of the operations described herein. Inaddition, methods described herein can be implemented by one or moredata processors either within a single computing system or distributedamong two or more computing systems.

The details of one or more variations of the subject matter describedherein are set forth in the accompanying drawings and the descriptionbelow. Other features and advantages of the subject matter describedherein will be apparent from the description and drawings, and from theclaims.

DESCRIPTION OF DRAWINGS

FIG. 1 is a box diagram illustrating an implementation of the system inan incubator.

FIG. 2 is a box diagram illustrating another implementation of thesystem in an open warmer.

FIG. 3 is a box diagram illustrating various operational mode of thesystem.

FIG. 4 is a flowchart illustrating a Warm-Up Mode operation.

FIG. 5 is a flowchart illustrating a Weaning Mode operation.

Like reference symbols in the various drawings indicate like elements.

DETAILED DESCRIPTION

Disclosed herein are devices, systems, articles, and methods toautomatically control and monitor the temperature change and rate ofwarming (or cooling) provided by patient incubators and warmers.

It should be appreciated that the devices, systems, articles, andmethods disclosed herein can be used for a variety of patient types andare not limited to neonates, infants or premature infants. Further, thedevices, systems, articles, and methods described herein can be usedwith incubators having generally an enclosed treatment space or warmershaving generally open treatment spaces.

System Components

FIG. 1 illustrates an implementation of a patient system 5 including apatient support unit including a lying surface such as a mattress 10 tosupport the patient that is surrounded at least in part by a hood 15.The system 5 can be positioned on a stand 7 or other support feature.The system 5 can include a heating module 20 that can include one ormore heating units to direct warming energy for different purposes suchas a main air heater 25, a mattress heater 30, and/or a humidity heater35 or other air warmer. The mattress heater 30 can provide heat to thepatient by contact between the patient and the mattress 10 or coveringssurrounding the mattress 10. Mattress heater 30 can be operationallycoupled to a mattress heater controller 115 that can be adjusted(manually and/or automatically) using the mattress temperature setting120.

The heating module 20 can also include one or more radiant heaters 40for providing heat to the patient by radiation. A radiant heater 40 istypically provided with warmers where the patient warmer has sidewallsbut is open to the top for operation with a radiant heater 40 (see FIG.2). Also as shown in FIG. 2, the radiant heater 40 can be operationallycoupled to a radiant heater control 125 that can be adjusted (manuallyand/or automatically) using a heater power setting 130.

The climate of the patient environment can also be controlled for oxygencontent and relative humidity. The system 5 can also include an oxygenvalve 45 and servo oxygen controller 50 configured to deliver controlledamounts of oxygen to the patient environment. The system 5 can alsoinclude a humidity controller 55 that can control the humidity heater 35to regulate the moisture content in the patient environment.

Control and monitoring of the system 5 can be provided using varioussensing and control systems. Still with respect to FIG. 1, the system 5can include an environmental sensor module 60 that can include one ormore air temperature sensors 65, an oxygen sensors 70 and a humiditysensors 75. Air temperature sensor 65 can measure the actual airtemperature in the closed patient environment. The air temperaturesensor 65 can be operationally coupled to an air temperature controller80. The air temperature controller 80 can be operationally coupled tothe main heater 25 and can be adjusted (manually and/or automatically)using an air temperature setting 85. The oxygen sensor 70 can beoperationally coupled to the servo oxygen controller 50. The servooxygen controller 50 can be operationally coupled to the oxygen valve 45and can be adjusted (manually and/or automatically) using an oxygensetting 90. Similarly, the humidity sensor 75 can be operationallycoupled to the humidity controller 55. The humidity controller 55 can beoperationally coupled to the humidity heater 35 and can be adjusted(manually and/or automatically) using a relative humidity (RH) setting95

Still with respect to FIG. 1, the system 5 can include one or morepatient skin temperatures sensors 100. The skin temperature sensors 100can be operationally coupled to a skin temperature controller 105. Theskin temperature controller 105 can be operationally coupled to the mainheater 25 and can be adjusted (manually and/or automatically) using askin temperature setting 110. A first skin temperature sensor 100 can bepositioned on the patient to measure core temperature such as on thehead, abdomen or lower back and a second skin temperature sensor 100 canbe positioned to measure peripheral temperature such as on a hand orfoot. It has been noted that hypothermia can be recognized in the caseof highly premature or full-term newborn babies from an intense coolingof the periphery, while the core of the body is still within a normalrange. The body can attempt to maintain the core temperature by reducingthe blood flow to the periphery via vasoconstriction, thus reducing heatloss to the environment at the periphery. Hyperthermia can be recognizedfrom a decrease in the peripheral temperature with rising coretemperature of the body. The body has centralized the blood flow to thecore in this case in order to heat to a higher temperature, and itthrottles the blood flow to the periphery in order to save heat and touse it to heat the central organs. A subsiding fever can be recognizedfrom the high core temperature of the body with a simultaneously highperipheral temperature. The body uses the large surface of the peripheryto cool the core of the body by a corresponding release of heat.

The system 5 can also include various indicators and/or alarms toindicate status of the device. For example, an alarm can sound when asensed condition (e.g. skin temperature, air temperature, oxygen,humidity, CO₂, etc.) is outside of a set range or limit. The indicatorand/or alarm may be a visual indication, auditory indication, tactileindication, and the like.

The monitoring and control of the system 5 can be provided by a controlsystem that can include at least one processor, at least one memorycoupled to the at least one processor and including at least one programstored thereon. The control system can also include a user interfacesystem 22 can include at least one display 23 including a graphical userinterface (GUI). The display 23 can vary including LCD, LED, plasma,OLED, and the like. The display 23 can be interactive or touch-sensitivescreen having an input device such as a touch screen, a capacitancescreen, a resistive screen or the like. The user interface system 22 caninclude one or more inputs 24 such as fixed buttons associated withfixed functions or changeable functions such as soft keys associatedwith the display 23. The soft keys can provide functions wherein thefunction is displayed and the display can change providing differentfunctions in different situations. The fixed input keys can also have afunction that changes depending upon the display provided. The system 5can include other inputs 24 such as a keyboard, mouse, bar code reader,or other input device that can be separate from the display 23. Thesystem 5 can also have the capability to operatively couple to asecondary display such as a PC, laptop, mobile communication device,smartphone, or personal digital assistant and the like.

The display can provide information to the user such as current skintemperature from one or more of the temperature sensors, current airtemperature, relative humidity, oxygen, heater module percent capacity,procedure or protocol being performed, operating mode, skin temperaturegoal, duration of intervals, and skin temperature increases per intervalstep, as well as other patient-specific information.

Various aspects of the subject matter described herein may be realizedin digital electronic circuitry, integrated circuitry, speciallydesigned ASICs (application specific integrated circuits), computerhardware, firmware, software, and/or combinations thereof. These variousimplementations may include implementation in one or more computerprograms that are executable and/or interpretable on a programmablesystem including at least one programmable processor, which may bespecial or general purpose, coupled to receive data and instructionsfrom, and to transmit data and instructions to, the memory, at least oneinput device, and at least one output device such as a display.

These computer programs (also known as programs, software, softwareapplications or code) include machine instructions for a programmableprocessor, and may be implemented in a high-level procedural and/orobject-oriented programming language, and/or in assembly/machinelanguage. As used herein, the term “machine-readable medium” refers toany computer program product, apparatus and/or device (e.g., magneticdiscs, optical disks, memory, Programmable Logic Devices (PLDs)) used toprovide machine instructions and/or data to a programmable processor,including a machine-readable medium that receives machine instructionsas a machine-readable signal. The term “machine-readable signal” refersto any signal used to provide machine instructions and/or data to aprogrammable processor.

Operational Modes

The systems 5 described herein can be configured to selectively operatein a variety of modes depending on the type of environmental control andmonitoring desired. Although the systems 5 described herein aredescribed as having automatic control and monitoring, it should beappreciated that the systems 5 are capable of being manually configuredand operated by the user.

FIG. 3 illustrates some of the modes of which the system 5 can operate.A user can be prompted by the system 5 to select a mode (300). Thesystem 5 can be operated according Skin Mode (305), Air Mode (310),Manual Mode (315), Warm-Up Mode (325), Weaning Mode (330), and CoolingMode (335). Control of the system 5 in Skin Mode 305 is based onachieving a desired skin temperature for the patient. A skin temperaturesensor attached to the patient's skin can sense the actual skintemperature of the patient. The system 5 can regulate the heating module20 to supply adequate heat to reach a desired skin temperature. Thesystem 5 can regulate the heating module 20 based on various programmedprotocols as will be described in more detail below. Control of thesystem 5 in Air Mode 310 is based on achieving a desired air temperatureof the patient environment. The sensor module 60 of the system 5 canprovide for measurement of the actual temperature inside the patientenvironment and regulate the heater module 20 to supply adequate heat toreach the desired air temperature. The automatic regulation can be basedon various programmed protocols as will be described in more detailbelow.

Warm-Up Mode

In some situations, it can be desirable to warm a patient, particularlya premature or full-term newborn baby or neonate, gradually over auser-defined time period and according to a specific programmed protocoluntil a target skin temperature is achieved. Warm-Up Mode 325 canincorporate Skin Mode 305 temperature control. In Warm-up Mode 325, theskin temperature set-point is not fixed and can be automaticallyadjusted by the system 5 according to the protocol selected until theskin temperature reaches the goal skin temperature. The system 5 followsthe user-defined protocol such that the user can selectively determinethe rate at which warm-up occurs. The Warm-Up Mode 325 also allows auser to avoid manually increasing the heating power of a heater in thesystem to achieve the desired target skin temperature. The system 5simplifies the warm-up procedure by providing an automatic mode togradually warm a patient thereby increasing patient safety and timesavings for medical care professionals.

FIG. 4 illustrates an example of a Warm-Up Mode operation. Upon start ofthe Warm-Up Mode 325, the system 5 can switch into Skin Mode 305.Warm-up Mode begins (400) and a user can be prompted to Set Goal SkinTemp (405), Set Step Duration (410) and Set Step Temp Increase (415).Set Goal Skin Temp (405), Set Step Duration (410) and Set Step TempIncrease (415) can also be pre-defined or pre-configured by the systemand respectively bypassed by the user upon initiation of Warm-Up Mode325. In some implementations, Goal Skin Temp can be between about 34° C.to 38° C. In some implementations, Step Duration can be at least about2, 4, 6, 8, 10, 12, 15, 18, 20, 22, 25, 28, 30 or more minutes. In someimplementations, Step Temp Increase can be between about 0.1° C. to 1.0°C.

Upon initiation of Warm-Up Mode, the system 5 can Determine SkinSet-Point (420), which is equal to the Current Skin Temp+Step TempIncrease. The system automatically Regulates Heating Module in Skin Mode(425) for the defined Step Duration as described above. The system canmonitor whether the Goal Skin Temp is reached (435). If the Goal SkinTemp has been reached, Warm-up Mode will end and the system 5 cancontinue operating in Skin Mode (445). If the Goal Skin Temp has notbeen reached, the system will determine the next Skin Set-Point (420 b),which is equal to the SkinSp1+Step Temp Increase. The system RegulatesHeating Module in Skin Mode (425 b) for the defined Step Duration. Thesystem monitor whether the Goal Skin Temp is reached (435 b). If theGoal Skin Temp has been reached, Warm-up Mode will end and the system 5can continue operating in Skin Mode (445 b). If the Goal Skin Temp hasnot been reached, the system will determine the next Skin Set-Point (420c), which is equal to the SkinSp2+Step Temp Increase. The systemRegulates Heating Module in Skin Mode (425 c) for the defined StepDuration. The system can monitor whether the Goal Skin Temp is reached(435 c). If the Goal Skin Temp has been reached, Warm-up Mode will endand the system 5 can continue operating in Skin Mode (445 c). If theGoal Skin Temp has not been reached, the system will determine the nextSkin Set-Point (420 d) and the operation carries on as described above.

The display 23 can indicate to the user that the system 5 is in Warm-UpMode 325 or that Warm-Up Mode 325 has ended. During Warm-up mode 325,Skin Mode alarm limits can apply and can generate respective alarms ifthe patient is not able to reach the desired temperature. It should beappreciated that the Warm-Up Mode 325 can be incorporated in open carewarming therapy as well as with closed care warming therapy such as anincubator.

Weaning Mode

In some situations, it can be desirable to wean a baby from a warmingenvironment gradually over time until a goal air temperature isachieved. Infants that are well and ready to be moved from theincubator, are typically weaned from the warming system based on age andgestation. Weaning Mode 330 allows for the air temperature of theincubator to be gradually scaled down according to a programmed protocolover a time until a certain air temperature is reached and the infant isable to maintain its skin temperature within an acceptable range. Theskin temperature of the infant is monitored by the system forfluctuations of temperature outside of the acceptable range. WeaningMode 330 provides for thermal challenges of the infant prior to transferand in turn can reduce the risk caused by thermal stress whentransferring from a closed warming environment to an open warmingenvironment and beyond.

Weaning Mode 330 can incorporate Air Mode 310 temperature control. InWeaning Mode 330, the air temperature set-point is automaticallyadjusted according to the selected pre-programmed protocol and the skintemperature of the infant monitored until the air temperature goal isultimately reached. Once the air temperature goal is reached without theskin temperature fluctuating outside the acceptable skin temperaturerange, the Weaning Mode 330 ends.

FIG. 5 illustrates an example of a Weaning Mode operation. Upon start ofthe Weaning Mode 330, the system 5 can switch into Air Mode 310. WeaningMode Begins (500) and a user is prompted to Set Goal Air Temp (505), SetStep Duration (510), Set Step Temp Decrease (515), Set Goal Skin Temp(512) and Set Weaning Abort Deviation (514). It should be appreciatedthat these parameters can also be pre-defined or pre-configured by thesystem and respectively bypassed by the user upon initiation of WeaningMode 330. In some implementations, Goal Air Temp can be between about20° C. to about 39° C. In some implementations, Step Duration can be atleast about 1 hour to at least about 24 hours. In some implementations,Step Duration can be at least about 1, 2, 4, 8, 12, 18, and 24 hours. Insome implementations, Step Temp Decrease can be between about 0.2° C. to1.0° C. In some implementations, Goal Skin Temp can be between about34.0° C. to 38.0° C. In some implementations, Weaning Abort Deviationcan be between about 0.3° C. to 1.0° C.

Upon initiation of Weaning Mode 330, the system 5 Determine Start SkinTemp (520) and Begin Level 1 (525). The system 5 automatically regulatesthe heating module 20 to the Start Air Temp reduced by the Step TempDecrease for the Step Duration to Begin Level 1 (525). Throughout theWeaning Mode procedure, the system 5 automatically monitors Skin Tempand assesses whether Skin Temp is equal to or greater than the Goal SkinTemp minus the Weaning Abort Deviation (535) to achieve the goal airtemperature while maintaining the goal skin temperature within theweaning abort deviation range. If Level 1 Skin Temp lies outside theweaning abort deviation range, then the system 5 can End Weaning Mode(545) and/or an alarm can sound. The system 5 can switch back to thelast temperature settings tolerated by the patient. If the Level 1 SkinTemp is within the deviation range, then the system 5 can assess whetherthe Goal Air Temp is achieved (540). If Goal Air Temp is achieved thenthe system 5 can End Weaning Mode (545) and a notification provided tothe user. If Goal Air Temp is not achieved then the system 5 will BeginLevel 2 (525 b). The system 5 can automatically set the heating module20 to the Level 1 Air Temp plus the Step Temp Decrease for the StepDuration to Begin Level 2 (525 b). After the Step Duration, the system 5can Determine Level 2 Skin Temp (530 b) and assess whether Level 2 SkinTemp is greater than the Goal Skin Temp minus the Weaning AbortDeviation (535 b). If Level 2 Skin Temp lies outside the deviationrange, then the system 5 can End Weaning Mode (545 b) and/or an alarmcan sound. The system 5 can switch back to the last temperature settingstolerated by the patient. If the Level 2 Skin Temp is within thedeviation range, then the system 5 can assess whether the Goal Air Tempis achieved (540 b). If Goal Air Temp is achieved then the system 5 canEnd Weaning Mode (545 b) and a notification provided to the user. IfGoal Air Temp is not achieved then the system 5 will Begin Level 3 (525c). The system 5 can automatically set the heating module 20 to theLevel 2 Air Temp plus the Step Temp Decrease for the Step Duration toBegin Level 3 (525 c). After the Step Duration, the system 5 canDetermine Level 3 Skin Temp (530 c) and assess whether Level 3 Skin Tempgreater than the Goal Skin Temp minus the Weaning Abort Deviation (535c). If Level 3 Skin Temp lies outside the deviation range, then thesystem 5 can End Weaning Mode (545 c) and/or an alarm can sound. Thesystem 5 can switch back to the last temperature settings tolerated bythe patient. If the Level 3 Skin Temp is within the deviation range,then the system 5 can assess whether the Goal Air Temp is achieved (540c). If Goal Air Temp is achieved then the system 5 can End Weaning Mode(545 c) and a notification provided to the user. If Goal Air Temp is notachieved then the system 5 will Begin Level 4 (525 d) and the operationcarries on as described above. It should be appreciated that the patientskin temperature is continually monitored. Thus, at any point during theWeaning Mode procedure if the patient skin temperature measured by thesystem falls outside the deviation range, the system 5 can End WeaningMode (545) and/or an alarm can sound.

When the Air Temp Goal is reached, and the Skin Temp of the patient doesnot fall below the Weaning Abort Deviation, Weaning Mode 330 is disabledby the system 5, which can continue to operate in normal Air Mode 310.Further, a message can be provided on the display such as “weaningcomplete” after the selected weaning stabilization time is completed.Further, if humidity controller 55 or the mattress temperaturecontroller 115 were enabled prior to the start of Weaning Mode 330,set-points for both humidity and mattress temperature can be set to automode.

Cooling Mode

In some situations, it can be desirable to cool a patient with anauxiliary device while the patient is still being monitored using thesystems described herein. For example, newborns who sufferhypoxic-ischemic birth injury can be treated with whole-body cooling tolimit neural damage and reduce the rate of neurological disorders suchas cerebral palsy. An auxiliary device such as a cooling blanket orother device can be introduced to the system 5 to treat the patient.Cooling Mode 335 is a passive mode that can allow for the whole-bodycooling of the patient while maintaining some of the patient-specificmonitoring and data acquisition and avoiding nuisance alarms.

Cooling Mode 335 can incorporate patient and device monitoring similarto Air Mode 310 or Manual Mode 315. In Cooling Mode 335, the systemautomatically switches off the heating module 20 (or radiant heater 40,if used with a warmer) and mattress heater 30 and disables respectivecontrols. The heater-related alarms (e.g. high/low air temperaturealarm, mattress temperature deviations) can likewise be disabled by thesystem. In the incubator, the fan circulating air within the incubatorenabling CO₂ washout, humidity control and servo oxygen control as wellas the humidity controller 55, the servo oxygen controller 50 can all bemaintained by the system during Cooling Mode 335. The Cooling Mode 335allows for active patient cooling inside the system 5 and allows forpatient-related data and skin temperature monitoring/alarming tocontinue while incubator heating and related alarms are avoided.

When used with open care warming therapy, the system 5 can switch into aManual Mode 315. The radiant heater 40 and the optional mattress heater30 can be switched off and their respective controls (radiant heatcontrol 125 and heater power setting 130, mattress temperaturecontroller 115 and setting 120) can be disabled while in Cooling Mode335.

In one implementation, Cooling Mode 335 can be selected for start by theuser and the system can switch into Air Mode 310 or Manual mode 315. Oneor more of the system heaters including the air heater 20, radiantheater 40, and/or mattress heater 30 can be disabled by the system ascan the respective alarm monitoring mechanisms for the system heaters. Amessage such as “Cooling Mode” can be displayed to the user. The systemprovides for and monitors the protective environment including oxygen,humidity, and developmental care features during cooling including alarmlimits as selected by the user. The system 5 leaves cooling mode uponselecting exit cooling mode.

The implementations set forth in the foregoing description do notrepresent all implementations consistent with the subject matterdescribed herein. Instead, they are merely some examples consistent withaspects related to the described subject matter. Wherever possible, thesame reference numbers will be used throughout the drawings to refer tothe same or like parts.

Although a few variations have been described in detail above, othermodifications or additions are possible. In particular, further featuresand/or variations can be provided in addition to those set forth herein.For example, the implementations described above can be directed tovarious combinations and sub-combinations of the disclosed featuresand/or combinations and sub-combinations of several further featuresdisclosed above. In addition, the logic flows and steps for usedescribed herein do not require the particular order shown, orsequential order, to achieve desirable results. Other embodiments can bewithin the scope of the claims.

1. A system, comprising: a patient support unit having an enclosedpatient environment; a heating module comprising a heater and a heatingmodule controller operatively coupled to the heater, wherein the heateris configured to warm the patient environment; a skin temperature sensormodule comprising a skin temperature sensor and a skin temperaturecontroller operatively coupled to the skin temperature sensor and to theheater, wherein the skin temperature sensor is configured to measure askin temperature of a patient in the patient environment; anenvironmental sensor module comprising an air temperature sensor and anair temperature controller operatively coupled to the air temperaturesensor and to the heater, wherein the air temperature sensor isconfigured to measure the air temperature in the patient environment;and a control system comprising at least one processor, at least onememory coupled to the at least one processor and including at least oneprogram stored thereon, and at least one input interface, wherein thecontrol system is configured to selectively operate the system in apre-programmed weaning mode configured to gradually wean the patientfrom the warmed patient environment according to a series of stepped airtemperature decreases performed over a series of stepped time durationsto achieve a goal air temperature while maintaining a goal skintemperature within a weaning abort deviation.
 2. The system of claim 1,wherein the heating module controller is regulated by the control systemto limit heating energy from the heater to achieve an air temperatureset-point within one in the series of stepped time durations, whereinthe air temperature set-point equals the air temperature of the patientenvironment measured at a start of one in the series of stepped timedurations plus one in the series of stepped temperature decreases. 3.The system of claim 1, wherein the weaning mode ends once the goal airtemperature is achieved and the skin temperature of the patient is equalto or greater than the goal skin temperature less the weaning abortdeviation.
 4. The system of claim 1, wherein the goal air temperature isbetween about 20° C. to about 39° C.
 5. The system of claim 1, whereinthe goal skin temperature is between about 34° C. to 38° C.
 6. Thesystem of claim 1, wherein each in the series of stepped air temperaturedecreases is between about 0.2° C. to 1.0° C.
 7. The system of claim 1,wherein each in the series of stepped time durations is at least about1, 2, 4, 8, 12, 18, or 24 hours.
 8. The system of claim 1, wherein theweaning abort deviation is between about 0.3° C. to 1.0° C.
 9. Thesystem of claim 1, wherein the environmental sensor module furthercomprises one or more oxygen sensors.
 10. The system of claim 9, whereinthe one or more oxygen sensors are coupled to a servo oxygen controlleroperationally coupled to an oxygen valve configured to delivercontrolled amounts of oxygen to the patient environment.
 11. The systemof claim 1, wherein the environmental sensor module further comprisesone or more humidity sensors.
 12. The system of claim 11, wherein theone or more humidity sensors are coupled to a humidity heater and ahumidity controller configured control the humidity heater to regulatemoisture content in the patient environment.
 13. The system of claim 1,wherein the heater comprises one or more of a main air heater, amattress heater, a radiant heater, or a humidity heater.
 14. The systemof claim 1, wherein the patient comprises a premature or full-termnewborn baby.
 15. A method, comprising: supporting a patient in apatient environment of an incubator, wherein the incubator comprises: aheating module comprising a heater and a heating module controlleroperatively coupled to the heater, wherein the heater is configured towarm the patient environment; a skin temperature sensor modulecomprising a skin temperature sensor and a skin temperature controlleroperatively coupled to the skin temperature sensor and to the heater,wherein the skin temperature sensor is configured to measure a skintemperature of the patient in the patient environment; an environmentaltemperature sensor module comprising an air temperature sensor and anair temperature controller operatively coupled to the air temperaturesensor and to the heater, wherein the air temperature sensor isconfigured to measure the air temperature in the patient environment;and a control system comprising at least one display, at least oneprocessor, at least one memory coupled to the at least one processor andincluding at least one program stored thereon, and at least one inputinterface; and receiving a command by the control system to perform apre-programmed weaning mode protocol configured to gradually wean thepatient from the warmed patient environment according to a series ofstepped air temperature decreases performed over a series of steppedtime durations to achieve a goal air temperature while maintaining agoal skin temperature within a weaning abort deviation.
 16. The methodof claim 15, further comprising prompting a user on the display toidentify one or more of the stepped air temperature decreases, thestepped time durations, the goal air temperature, the goal skintemperature, and the weaning abort deviation.
 17. The method of claim15, further comprising automatically measuring the current skintemperature of the patient using the skin temperature sensor andcontinuously communicating the measured current skin temperature to thecontrol system.
 18. The method of claim 17, further comprisingautomatically regulating the heater module to limit heating energy fromthe heater to achieve an air temperature set-point within one in theseries of stepped time durations, wherein the air temperature set-pointequals the air temperature of the patient environment measured at astart of one in the series of stepped time durations plus one in theseries of stepped temperature decreases.
 19. The method of claim 18,further comprising comparing the skin temperature of the patient to thegoal skin temperature over the step duration.
 20. The method of claim15, wherein the weaning mode protocol ends once the goal air temperatureis achieved and the skin temperature of the patient measured is equal toor greater than the goal skin temperature less the weaning abortdeviation.
 21. The system of claim 15, wherein the goal air temperatureis between about 20° C. to about 39° C.
 22. The method of claim 15,wherein the goal skin temperature is between about 34° C. to 38° C. 23.The method of claim 15, wherein each in the series of stepped airtemperature decreases is between about 0.2° C. to 1.0° C.
 24. The methodof claim 15, wherein each in the series of stepped time durations is atleast about 1, 2, 4, 8, 12, 18, or 24 hours.
 25. The method of claim 15,wherein the weaning abort deviation is between about 0.3° C. to 1.0° C.26. The method of claim 15, wherein the environmental sensor modulefurther comprises one or more oxygen sensors.
 27. The method of claim26, wherein the one or more oxygen sensors are coupled to a servo oxygencontroller operationally coupled to an oxygen valve configured todeliver controlled amounts of oxygen to the patient environment.
 28. Themethod of claim 15, wherein the environmental sensor module furthercomprises one or more humidity sensors.
 29. The method of claim 28,wherein the one or more humidity sensors are coupled to a humidityheater and a humidity controller configured control the humidity heaterto regulate moisture content in the patient environment.
 30. The methodof claim 15, wherein the heater comprises one or more of a main airheater, a mattress heater, a radiant heater, or a humidity heater. 31.The method of claim 15, wherein the patient comprises a premature orfull-term newborn baby